Organization
INFINITE CHANGE FAMILY THERAPY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KADRA OMEROVIC (CREDENTIALING)
(402) 421-1182
Entity
Organization
Contact information
Practice address
245 S 84TH ST STE L101, LINCOLN, NE 68510-2601
(402) 421-1182
(402) 465-8717
Mailing address
245 S 84TH ST STE L101, LINCOLN, NE 68510-2601
(402) 421-1182
(402) 465-8717
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
50896891202
—
NE
Enumeration date
08/18/2018
Last updated
08/18/2018
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